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This document serves as an acknowledgment of the confidentiality obligations and training related to the handling of sensitive patient information and other confidential data at Stony Brook University
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How to fill out Workforce & Electronic Information Access Confidentiality Acknowledgement Statement and Training Attestation

01
Obtain the Workforce & Electronic Information Access Confidentiality Acknowledgement Statement and Training Attestation form from your supervisor or human resources.
02
Read through the document carefully to understand the confidentiality agreements and training requirements.
03
Fill out your personal information, including your name, position, and date.
04
Review and acknowledge your understanding of the confidentiality policies and your responsibilities under the agreement.
05
Sign and date the document where indicated.
06
Return the completed form to your supervisor or the designated department as instructed.

Who needs Workforce & Electronic Information Access Confidentiality Acknowledgement Statement and Training Attestation?

01
All employees who access electronic protected health information (ePHI) in any capacity.
02
New hires during the onboarding process.
03
Temporary staff and contractors who will have access to sensitive information.
04
Employees who change roles or departments that require different access permissions.
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It is a formal document that acknowledges an individual's understanding of the confidentiality requirements related to workforce and electronic information access, confirming that they have received the appropriate training on these matters.
Typically, all employees, contractors, and any individuals who have access to sensitive electronic information within the organization are required to file this statement.
To fill out the statement, individuals must provide their personal details, acknowledge receipt of training, and sign to confirm their understanding of the confidentiality obligations.
The purpose is to ensure that individuals understand their responsibilities regarding the handling of sensitive information and to protect the organization's data integrity and security.
Individuals must report their name, job title, department, date of training completion, and a confirmation of their understanding of confidentiality obligations.
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